KENNETH M VANDERVELDE JR. (NPI# 1417925702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417925702 |
| Entity Type | Individual |
| Full Name | KENNETH M VANDERVELDE JR. |
| Credential | MD |
| Practice Address |
7775 Angling Rd Portage MI 49024 |
| Practice Telephone | 2693219970 |
| Practice Fax Number | 2693219972 |
| Mailing Telephone | 2693219970 |
| Mailing Fax Number | 2693219972 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | KV029466 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1395346 | 05 |
| Street Address |
7775 ANGLING RD |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144880881 | Christina M Kemple-wascher | Nurse Practitioner | 7775 Angling Rd, Portage, MI 49024-7427 | 2019-06-14 |
| 1326603424 | Morgan Valene Muchez | Dietitian, Registered | 7775 Angling Rd, Portage, MI 49024-7427 | 2019-05-03 |
| 1316466345 | Zane Stampfly | Physician Assistant | 7775 Angling Rd, Portage, MI 49024-7427 | 2017-09-11 |
| 1285076422 | Ashley Marie Stoehr | Physician Assistant | 7775 Angling Rd, Portage, MI 49024-7427 | 2013-07-29 |
| 1265441703 | Leslie A Price | Physician Assistant | 7775 Angling Rd, Portage, MI 49024-7427 | 2006-08-05 |
| 1952349862 | Bridget Sage Kenny | Physician Assistant | 7775 Angling Rd, Portage, MI 49024-7427 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457564395 | Joshua Martin Pogorelec | Surgery | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2007-05-08 |
| 1245312586 | Associates In Surgery, PC | Surgery | 3630 Willowcreek Rd, Suite 3, Portage, IN 46368-5075 | 2006-10-19 |
| 1538177480 | Carol Ada Pierce | Surgery | 2817 New Pinery Road, Divine Savior Healthcare Inc, Portage, WI 53901 | 2006-08-04 |
| 1497738637 | Robert E Schmus | Surgery | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508475237 | Dr Dayhim Pllc | Surgery | 12203 Shearwater Cir, Commerce Township, MI 48390-4260 | 2020-07-28 |
| 1922624923 | Dr Anthony Joseph Md Pllc | Surgery | 2330 S Milford Rd Ste 120, Highland, MI 48357-4982 | 2020-06-25 |
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1922623081 | Joon B Kim | Surgery | 1200 Michigan Ave Ste 655, East Lansing, MI 48823-4099 | 2020-06-14 |
| 1932724101 | Alec Jerry Raniwsky | Surgery | 22250 Providence Drive 7pmb Suite #703a, Southfield, MI 48075-4825 | 2020-06-12 |
| 1184245771 | Upper Michigan Associates LLC | Surgery | 1414 W Fair Ave Ste 235, Marquette, MI 49855-5406 | 2020-05-05 |
| 1245851427 | Adriana Sharp | Surgery | 1 Genesys, Grand Blanc, MI 48439 | 2020-04-29 |
| 1487275509 | Erika C Michelin | Surgery | 28080 Grand River Ave Ste 208, Farmington Hills, MI 48336-5966 | 2020-04-29 |
| 1063047629 | Suzanne A. Law, D.o., P.C. | Surgery | G4007 W Court St Ste E, Flint, MI 48532-3560 | 2020-03-04 |
| 1801454871 | Dakita Mack | Surgery | 28050 Grand River Ave Ste 208n, Farmington Hills, MI 48336-5919 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.